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Clinical Judgment Sample Items A  CLOSE Question 1 loaded rationals provided Question: 1 of 3 Use the following scenario and client data to answer the question. A nurse is preparing to administer medications to a client for whom the nurse has the following data: Diagnosis Major depressive disorder Vital signs BP 152/78 mm Hg Pulse rate 92/min Respiratory rate 18/min Oral temperature 36.7° C (98.1° F) O2 saturation 97% on room air Weight 97.7 kg (215 lb) Allergies Gentamicin Medical history Panic disorder Fibromyalgia Posttraumatic stress disorder Congestive heart failure Hypertension Laboratory Test Results Potassium 3.7 mEq/L Sodium 146 mEq/L BUN 18 mg/dL Hgb 15 g/dL Hct 54% ECG: normal sinus rhythm Diet Low-sodium Scheduled Procedures Electroconvulsive therapy (ECT) in 1 hr Medications to Administer Diazepam 5 mg oral twice daily Gabapentin 300 mg oral three times daily Atropine 0.4 mg IM 1 dose 30 min preprocedure Lisinopril 20 mg oral once daily Furosemide 40 mg oral once daily Succinylcholine 0.6 mg/kg IV during procedure Which three medications require clarification prior to administration? (Complete the following sentences by choosing from the dropdown lists. Do not use the same medication selection more than once.) The nurse should clarify the prescription for                   Select an option                  diazepam gabapentin atropine lisinopril furosemide succinylcholine               because                   Select an option                  the client is scheduled for ECT. administering the medication is outside the nurse’s scope of practice. of the client’s blood pressure. of the client’s allergy. the client has a history of congestive heart failure. of the client’s sodium level.               The nurse should clarify the prescription for                   Select an option                  diazepam gabapentin atropine lisinopril furosemide succinylcholine               because                   Select an option                  the client is scheduled for ECT. administering the medication is outside the nurse’s scope of practice. of the client’s blood pressure. of the client’s allergy. the client has a history of congestive heart failure. of the client’s sodium level.               The nurse should clarify the prescription for                   Select an option                  diazepam gabapentin atropine lisinopril furosemide succinylcholine               because                   Select an option                  the client is scheduled for ECT. administering the medication is outside the nurse’s scope of practice. of the client’s blood pressure. of the client’s allergy. the client has a history of congestive heart failure. of the client’s sodium level.              
SCIENCE
HEALTH SCIENCE
NURSING

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